Adia Banks, LCSW
Individual provider Active NPI Clinical Social Worker · Roanoke, TX
NPI 1104490499 · NPPES record last updated Apr 3, 2023
Key facts
- NPI
- 1104490499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 60709 (TX)
- Practice address
- 11216 Bull Head LN
Roanoke, TX 76262-1916 - Phone
- (972) 885-7097
- NPI assigned
- May 19, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210730000773 | TX | Practitioner - Clinical Social Worker | 2668875485 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60709 | TX | MD | Clinical Social Worker |
Interoperability endpoints
- adia.banks.1@30520.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 60709 | TX | Yes |
Addresses
Primary practice location
11216 Bull Head LN
Roanoke, TX 76262-1916
Mailing address
516 E Byron Nelson Blvd Unit 184
Roanoke, TX 76262-6210
Phone (972) 885-7097
Other providers in Roanoke, TX
- Rhea Theresa Coronel Antolin
- Roddrick Keith Armwood
- Amanda Kay Attaway
- Babies and Bellies Family Chiropractic PLLC
- Kimberley Anne Baker
- Be Good Healthcare Inc
- Taylor Jo Beaulieu
- Jenna Denise Beck
- John Belew
- Marilyn Josephine Benedict
All providers in Roanoke, TX · Clinical Social Worker in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.